Caring for the community: the role of partnerships.

While many members of the public are deeply interested in and supportive of the three traditional missions of academic medicine--education, research, and clinical care, they also want to know what academic health centers (AHCs) are doing to improve the overall health of their communities. Much is already being done toward this goal, but improving communities' health in a measurable way requires a far broader agenda. AHCs must bring together the approaches of medicine and public health, and need to partner with many other players. This agenda must proceed despite all the other challenges that AHCs are currently facing. The author reviews illustrative and emerging national, state, and local efforts, public and private, in both medicine and public health, in partnerships with individuals and institutions in the larger community. He also highlights the physician's role in assisting stakeholders' efforts to deal with health threats from the environment, and offers advice about how such efforts should proceed. He closes by emphasizing the importance of community-based research to learn about the health statuses, problems, and resources of particular communities, and presents a set of principles for such community-based research.